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neuronal activity in the locus creruleus5-7 and decreased noradrenaline release.8.9 While clonidine and the opiates have similar effects on the locus coeruleus, clonidine appears to exert specific effects through non-opiate, alpha-2 adrenergic receptors. 6, These data suggested that the opiate-withdrawal syndrome is due to increased noradrenergic neuronal activity in areas such as the locus coeruleus which are regulated both by alpha-2 adrenergic and opiate receptors. Our preliminary results in man support a noradrenergic system mediation of opiate withdrawal and suggest that clonidine may be a more definitive treatment for opiate withdrawal than others now available.

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3 siblings – 2 brothers aged 18 and 13 years, and 1 sister, aged 11 years – with adolescent or late-onset cystinosis presented with massive proteinuria. At the time their glomerular filtration rate was normal or only modestly diminished. Though glomerular injury was evident, renal tubular functional abnormalities were also present. Renal biopsy revealed histopathologic features typical of the nephropathic form of cystinosis with the Fanconi syndrome: polykaryocytosis, varying degrees of glomerular sclerosis, thickening and reduplication of basement membrane, fused foot processes, dilated tubules with altered epithelial cell features, and interstitial fibrosis. Fine granular deposits of C₃ and IgM are irregularly distributed in the glomeruli, findings which have not been described in cystinosis. These deposits are possibly immune complexes being deposited in the glomeruli unrelated to the cystine-storage disease or they may represent a localized activation of the complement system induced by the glomerular injury of cystinosis.

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